Predictive factors of positive online patient ratings of spine surgeons

BACKGROUND

Online physician rating websites are increasingly used by patients to evaluate their doctors. The purpose of this investigation was to evaluate factors associated with better spine surgeon ratings.

Patient satisfaction with and recommendation of a hospital: effects of interpersonal and technical aspects of hospital care.

OBJECTIVES: To examine patient satisfaction with and recommendation of a hospital, with a special focus on the correlation of these measures to patient ratings of interpersonal and technical performance of the hospital. DESIGN: Telephone survey of patients with four specific conditions after their discharge from hospitals. SETTING: Accredited district teaching hospitals and above, nationwide in Taiwan. PARTICIPANTS: A total of 4945 patients from 126 hospitals diagnosed with or undergoing procedures related to stroke, diabetes mellitus, Caesarean section, or appendectomy were interviewed by telephone. MAIN OUTCOME MEASURES: Overall patient satisfaction and recommendation were measured by single-item questions. Interpersonal skills were measured by three items: doctors' explanation, attitude, and caring. Technical skills were measured by another three items: hospital equipment, clinical competence, and outcome of treatment. RESULTS: Interpersonal skills were as influential or more influential than clinical competence on patient satisfaction for three of the four disease categories. In contrast, technical competence was a more influential predictor for recommendation for patients in all four disease categories. CONCLUSION: The preliminary results imply that a hospital with high percentage of patient satisfaction does not necessarily receive a high level of recommendation. This finding provides new insights for researchers and for hospital managers who devote resources exclusively for achieving the highest possible levels of patient satisfaction.     

The meaning of good sleep: a longitudinal study of polysomnography and subjective sleep quality

SUMMARY  The present study sought to investigate the meaning of subjectively good sleep, using a longitudinal and intraindividual design. Eight subjects slept in an isolation unit according to an irregular schedule of 6h sleeps and 1h naps, designed to give normal amounts of time in bed (1/3 of total), but variable sleep quality. Eight sleeps and eight naps were used for longitudinal simple and multiple regression analyses with standard polysomnographical sleep variables as predictors and subjective sleep quality as dependent variables. The results showed that subjective sleep quality (and related variables) was closely related to sleep efficiency, but not sleep stages. At least 87% efficiency was required for ratings of 'rather good' sleep. In addition, sleep quality ratings improved with closeness (of the awakening) to the circadian acrophase (17.00–21.00 hours) of the rectal temperature rhythm. The subjective ease of awakening differed from most other other variables in that it was related to low sleep efficiency. Objective and subjective homologues of sleep length and sleep latency showed high mean intraindividual correlations ( r = 0.55 and 0.64, respectively). It was concluded that objective measures of sleep continuity were closely reflected in perceived sleep quality and that sleep quality essentially means sleep continuity.     

肝硬化患者血清胆碱酯酶与透明质酸和Child-Pugh分级的关系

目的 探讨肝硬化患者血清胆碱酯酶(CHE)活性与透明质酸(HA)和Child-Pugh分级的相关性。方法 采用速率法和放射免疫法(RIA)测定了81例肝硬化患者、对照组30例血清CHE活性和肝纤维化标志物HA水平。结果 肝硬化Child-A、Child-B、Child-C级患者,CHE活性依次降低,肝纤维化标志物HA水平依次升高,且相差显著。CHE活性与HA水平呈显著负相关。CHE活性降低和HA水平升高与Child-Pu小分级具有一致性。结论 血清CHE活性水平可反映肝硬化的严重程度,血清CHE活性是评估肝硬化患者肝组织纤维化敏感而准确的指标,对评估手术治疗风险、病情变化及预后有一定的临床参考价值。     

Acute and chronic caffeine administration increases physical activity in sedentary adults

Caffeine is a commonly used stimulant thought to have ergogenic properties. Most studies on the ergogenic effects of caffeine have been conducted in athletes. The purpose of this study was to test the hypothesis that caffeine reduces ratings of perceived exertion and increases liking of physical activity in sedentary adults. Participants completed treadmill walking at 60% to 70% of their maximal heart rate at baseline and for 6 subsequent visits, during which half of the participants were given caffeine (3 mg/kg) and half given placebo in a sports drink vehicle. To investigate the potential synergistic effects of acute and chronic caffeine on self-determined exercise duration, participants were rerandomized to either the same or different condition for the last visit, creating 4 chronic/acute treatment groups (placebo/placebo, placebo/caffeine, caffeine/placebo, caffeine/caffeine). Participants rated how much they liked the activity and perceived exertion at each visit. There was a main effect of time on liking of physical activity, with liking increasing over time and an interaction of sex and caffeine treatment on liking, with liking of activity increasing in female participants treated with caffeine, but not with placebo. There was no effect of caffeine on ratings of perceived exertion. Individuals who received caffeine on the final test day exercised for significantly longer than those who received placebo. These data suggest that repeated exposure to physical activity significantly increases liking of exercise and reduces ratings of perceived exertion and that caffeine does little to further modify these effects.     

Stages of Residential Treatment

In this paper, the author identifies the contributions of a developmental-psychoanalytic model to the residential treatment of severely disturbed children. Utilizing the development of the self as an organizing principle, the author describes five patterns of self-other interaction: complementary (holding), sharing (attuning), facilitating, aversive, and sensual-sexual. Narcissistic vulnerability is related to the discrepancy between the actual self (one's real competence) and ideal self (the shape of the self capable of optimally meeting internal and external demands). The transition to autonomy, self-regulation, and self-cohesiveness is discussed with particular emphasis on the role of omnipotence and transitional phenomena in promoting, respectively, practicing and internalization. As a result of normal negotiation of these tasks of development, narcissistic vulnerability decreases. Failure in relinquishing omnipotence and/or achieving self-regulation are correlated with spectrum of disorders- the borderline-narcissistic spectrum. Residential treatment is described as attempting to provide a holding, attuning and facilitating environment where developmental distortions can be corrected.     

Microanalytic coding versus global rating of maternal parenting behaviour

This study examined the relationship between microanalytic coding and global rating systems when coding maternal parenting behaviour in two contexts. Observational data from 55 mother–child interactions with two- to four-year-old children, in either a mealtime (clinic; N?=?20 or control; N?=?20) or a playtime context (community; N?=?15), were coded via both microanalytic and global systems. Results from the microanalytic coding and global rating demonstrated similar results, with both scales showing adequate psychometric properties. No difference was found in the sensitivity of the two systems in the control sample; however, the global method demonstrated more sensitivity in measuring behaviour in the playtime context. This finding may indicate that global ratings are more sensitive in a population with high base rates of positivity or in a playtime context. This study highlights the incongruence of different measurement methods and emphasises the importance of considering coding methodology for different types of populations.     

The Hierarchical Clustering of Clinical Psychology Practicum Competencies: A Multisite Study of Supervisor Ratings

Competency evaluation rating forms are widely used to assess a range of global and specific psychology practitioner competencies during and at the end of clinical placements. Surprisingly, there is little research examining the dimensional structure or the hierarchical clustering of items on these ratings. The current, multisite study examined supervisor ratings of clinical psychology trainees (N = 204) on the Clinical Psychology Practicum Competencies Rating Scale (CΨPRS). Based on the proximity criterion chosen, hierarchical clustering yielded either nine clusters or four super clusters: Good Practitioner Attributes and Conduct, Scientist Practitioner and Professional Management, Assessment and Intervention, and Psychological Testing. The study also tracked the developmental trajectory of competency attainment. CΨPRS ratings differentiated groups between early but not between later stages of training. Measurement issues and implications for training and practice are discussed.     

Sleep Polysomnography and Reported Stress Across 6 Weeks

Despite the common notion that stress impairs sleep there is little published data showing that sleep (polysomnography (PSG)) is impaired across several sleep episodes in individuals who complain of daily stress during the same period. The present paper aimed at investigating such a connection. 33 subjects had 3 sleeps recorded with PSG at home across 6 weeks and kept a sleep/wake diary each day, including 3-hourly ratings of stress (scale 1–9). The stress ratings and the conventional PSG parameters were averaged across time. A stepwise multiple regression analysis showed that the best predictors of stress were Stage 1 sleep (beta = 0.49), latency to Stage 1 sleep (0.47) (adjusted for anxiety and age). Other sleep continuity variables had significant correlations with stress (reversed) but did not enter the multiple regression analysis. The correlation between stress before the start of the study and PSG data was not significant. It was concluded that moderately increased stress over a longer period of time is related to moderate signs of disturbed sleep during that period. This may be of importance when considering stress as a work environment problem.